MOUD (Medication for Opioid Use Disorder) Best Practices

MOUD Basics

How to Get a Waiver

HHS Announcement of Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder – Changes are Pending Review by New Administration (U.S. Department of Health and Human Services)

We are continuing to watch for updates on the MAT X-waiver, which HHS proposed to be dropped but now is on hold pending review by the new administration.

Physicians

Advanced Practice Registered Nurses (APRN) (NP/CNM/CNS/CRNA)

Physician Assistants (PA) MAT

General/ All Prescriber Training Sites

Clinical Basics

TIP 63: Medications for Opioid Use Disorder—Executive Summary & Full Document

Substance Abuse and Mental Health Services Administration (SAMHSA)

Topics covered:

  1. Introduction to Medications for Opioid Use Disorder Treatment
  2. Addressing Opioid Use Disorder in General Medical Settings
  3. Pharmacotherapy for Opioid Use Disorder
  4. Partnering Addiction Treatment Counselors With Clients and Healthcare Professionals
  5. Resources Related to Medications for Opioid Use Disorder

The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder—2020 Focused Update

The ASAM guideline includes recommendation on treatment of opioid use disorder and prevention of opioid and prevention of opioid-related overdose deaths.

The ASAM guideline website includes additional information:

  1. Executive Summary
  2. Full guideline
  3. Pocket guide
  4. Link to webinar on OUD treatment for adolescents and young adults

Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) January 2018 (National Institute on Drug Abuse (NIDA))

Buprenorphine (Substance Abuse and Mental Health Services Administration (SAMHSA))

Methadone (Substance Abuse and Mental Health Services Administration (SAMHSA))

Naltrexone (Substance Abuse and Mental Health Services Administration (SAMHSA))

Special Populations

Patients in Pain

The ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use – 2015 (American Society of Addiction Medicine (ASAM))

See Part 9 (page 43): Special Populations: Individuals with Pain

TIP 54: Managing Chronic Pain in Adults With or in Recovery From Substance Use Disorders – January 2012 (Substance Abuse and Mental Health Services Administration (SAMHSA))

Includes Literature Review and Guidance

Treatment of Pain in Patients Taking Buprenorphine for Opioid Addiction (Palliative Care Network of Wisconsin)

How do I co-manage pain? What meds do I use to manage pain?

ICSI Perioperative Guideline for Patients undergoing Surgery (ICSI)

Benzodiazepines

FDA Drug Safety Communication: FDA urges caution about withholding opioid addiction medications from patients taking benzodiazepines or CNS depressants: careful medication management can reduce risks (Current as of 9/26/17) (Food and Drug Administration (FDA))

Important: Check FDA website frequently for new updates

FDA Requiring Labeling Changes for Benzodiazepines: Boxed Warning to Be Updated to Include Abuse, Addiction and Other Serious Risks (Current as of 9/23/20) (Food and Drug Administration (FDA))

Important: Check FDA website frequently for new updates

Pregnancy

Perinatal Opioid Use Disorder (OUD) ECHO Series (Hennepin Healthcare ECHO)

Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants – January 2018 (Substance Abuse and Mental Health Services Administration (SAMHSA))

Adolescents

TIP 31: Screening and Assessing Adolescents for Substance Use Disorders – June 2012 (Substance Abuse and Mental Health Services Administration (SAMHSA))

Screening Tools for Adolescent Substance Use (National Institute on Drug Abuse (NIDA))

Demystifying Buprenorphine Prescribing for Youth With Opioid Use Disorders (Providers Clinical Support System (PCSS))

Medication-Assisted Treatment: Identifying the Need for Youth and Young Adult-Specific Strategies and Current Initiatives (Webinar & Audio) (Medicaid Innovation Accelerator Program (IAP))

Harm Reduction

Opioid Overdose Prevention

Opioid Overdose Prevention Toolkit (Substance Abuse and Mental Health Services Administration (SAMHSA))

Links to the following:

  1. Opioid Overdose Prevention Toolkit
  2. Opioid Use Disorder Facts
  3. Five Essential Steps for First Responders
  4. Information for Prescribers
  5. Safety Advice for Patients and Families Members
  6. Recovery from Opioid Overdose.

Naloxone (MN Department of Health)

Expanding Naloxone Access for Preventing Opioid Overdose – includes training resources (MN Department of Health)

Naloxone Booklet Infographic (CA Bridge)

Guide to Naloxone Distribution (CA Bridge)

CA focused, however includes useful/helpful tips/tools. Look at MDH Website

Suicidal Thoughts and Behaviors

TIP 50: Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment – October 2015 (Substance Abuse and Mental Health Services Administration (SAMHSA))

Pregnancy

Perinatal Opioid Use Disorder (OUD) ECHO Series (Hennepin Healthcare ECHO)

Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants – January 2018 (Substance Abuse and Mental Health Services Administration (SAMHSA))

Adolescents

TIP 31: Screening and Assessing Adolescents for Substance Use Disorders – June 2012 (Substance Abuse and Mental Health Services Administration (SAMHSA))

Care Team Training

Staff Education

Trauma Informed Care

MN Community ECHOs
Regulations

PDMP

Confidentiality

DEA

Patient Education

Resources for patients, family and friends

Information on Medications